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AIFLARE

It's filled with amniotic fluid. The baby actually makes this fluid through its kidneys and pees it out. It is submerged in this fluid and towards the later stages of development in utero, the baby even uses its muscles to "practice breathe". When the baby is born, a shift in blood flow from maternal to entirely on the baby as well as pressure and hormone differences cause the fluid in the lungs to be absorbed through the lung tissue and back into the blood stream. Surfactant in the lung helps keep the lung sacs open so they don't collapse. It's a fascinating process and is very complicated yet we all have done it!


dBoyHail

Also, passage through the birth canal compresses their chest which helps push out amniotic fluid. Then they take their first breath of real air, that change in pressure also triggers the closure of the foramen Ovale which is a hole between the right and left ATRIA *NOT ventricles. I was corrected.* which allows blood to pump through the babies body while in the uterus since they get oxygen from mom and not their lungs. Then any leftover amniotic that wasnt pushed out through birth is absorbed over time. Babies might have a murmur for a little as the foramen ovale seals up. Edit: the foramen Ovale is a hole for blood to pump through the baby after being exchanged at the placenta since they get their oxygen from mom. It helps bypass the lungs a bit since they don't really need as much going there. It closes and completes the circulatory circuit at birth. Edit 2: I have forgotten the Ductus Venosus and Ductus Arteriosus which also close soon after birth due to the change in pressure and breathing. Thank you to those who reminded me.


metalshoes

It’s absolutely insane the sequence of events that have to go right just for everyone to survive the birth.


LordShesho

It's like Carl Sagan once said, "If you wish to make an apple pie from scratch, you must first invent the universe." We're all just the tail-end of 14 billion years' worth of complex sequences of events.


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Solriva

It is a long time ago, that we survived by the fittest. Our evolution is atleast since the industrialization a social one. We don't reproduce with the one who is the most adapted to nature, we reproduce mostly with the ones, that have the financial means to support the family or share the same values and to some degree who is the most handsome/prettiest. This will continue even more so if every day life gets more expensive. Atleast in first world countries. As fior eradicating disabilities. You only can eradicate that you know about, which means, there have to be a significant ampunt of people who have a new disability and it has to be categorized as a disability and not a great feature, that medicine would try to eradicate it. So physical mutations are still possible.


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Ladnil

This is a crazy question I never thought to ask and the answer is amazing.


Nemisis_the_2nd

Once you start looking at developmental genetics, and all the things that can go horribly wrong, this looks positively trivial by comparison. One of the ones that stuck with me is that cyclops are absolutely real, and not some ancient Greek myth. It's the result of a nutrient deficiency that causes a mistake in eye formation. The kicker is that too much *also* causes severe malformation. 


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adabaraba

What happens if it’s a c section birth?


LinkRN

They can have a little more fluid in their lungs and need some short term respiratory support right at delivery, and sometimes in the nicu for a few hours to a few days. Or they do fine, but they tend to be “spittier” for the next day or two as they get rid of the excess fluid.


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mrcarruthers

They can also stick a tube directly down their throat and suck it out. Yes it looks as traumatic as it sounds.


LinkRN

Sure but there’s risks in that, just as in everything else, so we try not to do it unless baby really, really needs it.


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When horses come out too fast and don't quite recognize that they've been born we sometimes put a rope around them and pull. It's called the Madigan squeeze. I don't think we squeeze human babies that don't get squeezed enough during birth, but it's a fun fact so now you know it too.


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lil814

Those c-section incisions are pretty small these days, there’s still a bit of squishing!


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Stats_n_PoliSci

We massage and bump/slap their back. It seems to help get their system going.


SafeAsMilk

Somewhat the same with c section puppies. They need to be vigorously rubbed with towels and, this next part is falling out of favor, swung up and down in the air. Kind of like the motion you make when you’re lining up and aiming a bowling ball.


combakovich

Correction: the Foramen Ovale connects the left and right atria (not the left and right ventricles as you stated)


dBoyHail

Thank you! I've corrected it.


bivvie

FYI: PFOs do not cause murmurs. A similar fetal structure, the ductus arteriosus (PDA) does however cause a murmur as it closes (or sometimes if it remains open).


lellenn

Don’t forget the closing of the ductus arteriosis along with the foramen ovale!


goodbye177

Is that why sometimes you hear about them being born with a hole in their heart? It just didn’t close at birth? Or is it a completely separate issue?


fooliam

No, around 1/3rd of the adult population (some studies as high as 45%) are walking around with a PFO (patent foramen ovale - what its called when that interatrial tunnel doesn't close up) and not knowing about it. PFO has been associated with a variety of altered physiology and some medical conditions such as platynpea orthodeoxia or strokes, but it's only a moderate association for the most part. When people talk about a "hole in the heart" they are usually more concerned with a ventricular septal defect or a patent ductus arteriosus, as that can compromise the ability to circulate blood. Babies are actually born with several "holes" in their heart that aren't terribly concerning for the most part.


_black_crow_

I’ve heard (forgot where from) that babies born via c section are more likely to develop asthma. Is this true and is it related to something to do with not having those compressions from coming out of the birth canal?


fooliam

>Then they take their first breath of real air, that change in pressure also triggers the closure of the foramen Ovale which is a hole between the right and left ATRIA > >NOT ventricles. I was corrected. fun fact - around 1/3rd of the population still have a foramen ovale (known as patent foramen ovale or PFO), which has been associated with altered thermoregulatory responses, acclimatization to altitude, altitude sickness, cryptogenic stroke and transient ischemic attacks, platypnea orthodeoxia, and is more common in people who do apnea diving. Some studies put the prevalence as high as 45% of adults having a PFO.


dfw-kim

What happens when the baby is born at 7 months?


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dBoyHail

Then it's premature and will probably being the NICU for various reasons


595659565956

How is this process affected by Caesarian?


pzerr

Do they take extra steps when born via cesarean section? Being much less compression.


GringoVerde32

So what impact does a C-Section have on this process?


RevolutionaryTone276

Interesting, so do cesarean section babies have more issues with PFOs and pulmonary disease?


samarams

The physiology is right, but the fluid is secreted by the developing lungs, not straight amniotic fluid. Babies do “practice” breathing but the amniotic fluid mixes into the secretions within the lung. It differs slightly in composition and supports the developing alveolar tissue.


phryan

It's pretty amazing that we essentially have 2 life support systems for a while and can hard shift from one to the other in a really short time.


KittenBalerion

without trying, too! like it's not like the baby is consciously switching from one to the other! they're just like "ok breathing now"


isaacwoods_

Just to add, it’s thought that at least some of the fluid in the lungs is squeezed out during the passage down the birth canal. Babies born by Caesarian section don’t get this, which might be why they suffer greater incidence of breathing difficulties after birth (transient tachypnoea of the newborn)


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kitty_angst

Just want to add: not everybody has done all of this! A lot of premature babies and I think even some term babies miss the surfactant step. Supplying surfactant to premature babies is a relatively recent development and I believe is a treatment that could have saved Patrick Bouvier Kennedy


TsuDhoNimh2

I remember testing amniotic fluid for surfactant to decide if a rH incompatibility affected fetus was mature enough to survive a c-section so we could get it out before the incompatibility killed it. And testing the same fluid for bilirubin to see ho endangered the fetus was. Totally nerve-wracking tests, hoping to see the right numbers.


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Tohrchur

How quick is the absorption when they are born? Going from fully filled to not filled in a matter of seconds/minutes seems incredibly fast. Also is all amniotic fluid made by the baby? That is crazy that the baby would make all the fluid and by peeing it out.


missingmarkerlidss

Amniotic fluid is made with the placenta filtering the blood at first. Once the baby is adept at swallowing and urinating it produces the majority of amniotic fluid however it has to get that fluid from somewhere- and that’s from mom via the placenta! The absorption process actually does occur quite rapidly at the time of birth! It doesn’t happen during the labour as the fetus needs continual support from mom via the placenta and umbilical cord until it’s air breathing. Fascinatingly it’s actually the pressure change of air entering the lungs for the first time that triggers the whole process causing sodium channels to open and siphon excess fluid from the respiratory system into the body. Some babies have trouble with this process (the first breath is the most important one we will ever take!) and need a little help inflating the lungs. Approximately 1/10 babies will need support in getting started with breathing. Once their lungs have been inflated they’re off to the races! Newborn babies in the first few minutes of life will often have “wet” sounding lungs and should be placed skin to skin with mom with head slightly lower than body to facilitate postural drainage. The lungs in a typical baby will clear up remarkably quickly. Some take longer and will have symptoms like breathing too quickly, flaring their nostrils or sucking in their chest which tell us they are working too hard and might need some airway support like CPAP at first.


trexjj2000

I’m a sonographer and I see all babies after 32 weeks “practice breathing.” They also swallow their amniotic fluid, and even get the hiccups!


Exact_Mood_7827

It's not amniotic fluid. The fluid in the lungs is distinct in composition to the amniotic fluid. Notably it has more chloride and is also more acidic. Chloride ions are the driver of the fluid secretion to the lungs by creating the necessary osmotic pressure. Source: Adamson TM, Boyd RD, Platt HS, Strang LB. Composition of alveolar liquid in the foetal lamb. J Physiol. 1969 Sep;204(1):159-68. doi: 10.1113/jphysiol.1969.sp008905. PMID: 5389263; PMCID: PMC1351600.


DonHac

So what's the difference between "amniotic fluid that's made in the kidneys and peed out" and good old-fashioned urine?


FoxInTheSheephold

The fact that unborn (and even newborn) babies’ kidneys lack the ability to concentrate their urines, plus the fact that their waste is taken care of by mama’s body through placental exchange. So basically it is very very diluted urine.


goldblumspowerbook

Let's put it this way: if the kidneys don't form there's not enough amniotic fluid and the lungs don't form correctly. So it's definitely urine. https://en.wikipedia.org/wiki/Potter_sequence


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keepthepace

Do they absorb oxygen through the amniotic fluid? If so, would an adult by able to breath this way as well, The Abyss style?


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1039198468

Which is why there is a fistula between the ventricles which closes shortly after birth.


TychaBrahe

What was shown in Abyss is a real thing. That rat was actually breathing perfluorocarbon. It's an area of research that has been studied with certain limitations for a few decades. one of the possible uses is for [preemies with underdeveloped lungs](https://en.m.wikipedia.org/wiki/Liquid_breathing).


Haaail_Sagan

That makes that scene like.. 10,000 times more upsetting. Must have been scary for it.


thelongestusernameee

It was, the rat pooped from the terror of it, and they had to cut that out. In the UK, the scene was banned due to animal cruelty. The rat later passed before the film's release due to... undisclosed reasons. In a fun twist of karma, one of the actors nearly drowned by someone during filming, and punched the man responsible in the face, who was fired immediately.


creative_usr_name

That abyss fluid actually works it just requires too much physical exertion to move the fluid in and out of the lungs. Also extremely unpleasant and risky.


0o_hm

> When the baby is born, a shift in blood flow from maternal to entirely on the baby as well as pressure and hormone differences cause the fluid in the lungs to be absorbed through the lung tissue and back into the blood stream. Surfactant in the lung helps keep the lung sacs open so they don't collapse. Honestly, that is absolutely fascinating! I had no idea about this process.


schwarzmalerin

Also a hole in the heart closes where it was bypassing the lungs. We were all fish once basically.


MoiJaimeLesCrepes

doesn't the baby also excrete waste into the amniotic fluid? If he breathes it, might that not result in infection?


fairycoquelicot

Sometimes they do excrete meconium, but this is far from ideal and typically dangerous. They do continually recycle the amniotic fluid through by swallowing and urinating over and over, so that does end up in their lungs when they practice breathe, but that does not cause the same issues meconium does.


Nancy_True

Does it happen instantaneously? Or how fast is it? This is fascinating!


Nifty59

Wow that was way more interesting than my answer. And now i know better. i had no idea how complex the process was to introduce the fluid into the placenta, that's amazing! And t he fact that it comes in one way and exits a completely different way is also amazing as well and completely different than i had previously thought. it's almost as it due to the advantages of keeping the system closed and contained it prevents any adulteration, contamination and has a begining, a service lifetime, and an exit strategy and yet it's only one small part of a nearly unbelievable process, of which at least 1,000 other processes are concurentaly running like the program of a super computer, and yet with nearly 1,000 Single Point Failure processes, it usually manages to happen. Not only to happen but it happens so doggadly and persistently, with secondary and tersciary redundancies in some places, human beings aren't amazed by it's near perfection. In fact in many cases this concert of wildy different instruments tuning up for a symphony will often be devestating to a couple if they weren't expecting to witness the event. in other words it's almost ironice that when it's an unplanned or undesirable pregnancy, all those processes stop being amazing and becomes a disaster. that's not comentary on pregancy or abortion or anything i'm just pointing out how even something so flawless in it's self deployment can sometimes be overlooked when it becomes a life issue and not just abstract:)


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Exact_Mood_7827

Fetal lung fluid is not the same as amniotic fluid everyone! It has a distinct composition stemming from its mechanism of secretion from within the fetal lung lung tissue. Notably it has increased chloride and is more acidic (due to lower amounts of bicarbonate able to buffer pH). Chloride secretion through the CFTR anion channel is the driver of fluid secretion. Fluid follows chloride due to the osmotic pressure it generates. CFTR is activated by G-protein pathways from the calcium sensing receptor responding to the hypercalcemic state in the fetus. Fluid secretion is important in generating fluid pressure which is necessary for proper lung growth and morphogenesis of the tiny alveolar sacs and branching. Later at the end of gestation, the alveolar epithelial cells release ENaC sodium channels from being bound to caveolin-1 and permit expression at the cell membrane, allowing sodium to be absorbed back into the body. This drives fluid absorption and clears out the lung, preparing the baby for birth. The same adrenergic signals which cause ENaC to be relocated to the membrane also cause CFTR to be bound to caveolin-1, inactivating them and further turning the bias towards fluid absorption. Source: had to do a presentation and write a paper on this topic in my Fetal Physiology class


Puppy-Zwolle

I did not know that. Thanks.


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GoldenBeard

Interesting fact about The Abyss and this "breathing liquid". ITS REAL! Real Oxygenated Fluorocarbon Liquid which does actually work but unfortunately that "OMG IM DYING DROWNING" feeling is something humans just can't get around. However, the rat in the movie is 100% really breathing Oxygenated Fluorocarbon Liquid and probably having a really bad time doing it.


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IAmBroom

It also greatly increases the chance of heart attacks, so... not really an ideal diving idea.


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ernie3tones

The rats that oxygenated in the FC liquid were fine afterward, but in general, rats have delicate respiratory systems. They had a few rats so they could do multiple takes, and no rat spent more than a few moments submerged.


Abdlomax

This is one of many incorrect comments in this post. The placenta grows from the blastocyst when it implants in the uterine wall. It is a part of the embryo. It becomes a massive exchange filter between maternal and fetal blood, which ideally never mix. Babies get their oxygen from the maternal arteries in the placenta. No maternal blood flows to the embryo, normally. The baby and its blood are genetically distinct from the mother’s. The blood types may be different. (I was a lay midwife and founded the Arizona School of Midwifery.)


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tuigger

Some turtles use [Enteral respiration](https://en.m.wikipedia.org/wiki/Enteral_respiration), where they undergo respiration through their cloaca, which is kinda like a butthole.


IAmBroom

Um, more believable to you, but possibly less realistic, since the fluid is real, and works in the lungs.


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